HEALTH CARE ETHICS, Sixth Edition

Harold W. Baillie, John McGeehan, Thomas M. Garrett, Rosellen M. Garrett

Chapter 1

Ethics, Professional Ethics,

and Health Care Ethics

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Practical Wisdom:
An approach to ethical reasoning that not only examines actions and
their consequences, but also questions why we understand particular
events to be significant at all; that is, why is this action or result
important for us as humans?

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Focus Question:

When we say our actions are good or right, how do we explain what
that means and why we are correct?

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Emotions and the Ethical Life

• Emotions influence our ability to perceive ethical values and to

make ethical judgments.

• For practical ethics: emotions color our perception of the world

and inform our judgments of actions in that world.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Human Nature and Ethics
• The true subject matter of ethics is human nature, its core and its
limits.
• The basic questions raised in health care ethics: informed
consent, professionalism, just distribution, death, enhancement
genetic or otherwise, require for any answers a meditation on
human ethics.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Theories of Ethics
• Theories about the characteristics of human activity
Four theories:
• Consequentialism
• Kantian Deontologism
• Natural Law
• Virtue Ethics

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Consequentialism
• Sees the rightness or wrongness of an action in terms of the
consequences brought about by that action.
• Utilitarianism: a form of consequentialism – one should act so as
to do the greatest good for the greatest number.

Case Study:
• Ethical analysis of contraception – a utilitarian will look at it from
the perspective of the concerns of the individual or the society.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Kantian Deontologism
• The idea that an act can be described as good and what ought to
be done because it expresses certain characteristics such as
universality or conformity with the moral law.

Case Study
• A deontologism views contraception as wrong because it
violates the obligation to never use a person simply as a means.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Natural Law
• Rational reflection on nature, particularly human nature, will yield
principles of good and bad that can guide human action toward
human fulfillment or flourishing.

Case Study
• Natural law theorists tend to condemn contraception as
unethical – they believe there is a natural order that identifies the
procreative consequences of sexual activity as the key purpose
of that activity.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Virtue Ethics
• broadly defined involves the integration of virtues with what has
been called practical wisdom.
• Practical wisdom is the ability to choose patterns of action made
desirable and revealed as desirable by reasoning that has been
informed by habits of emotional experience and the consideration
of the widest possible range of experiences.

Case Study
• Virtue ethics theorists believe contraception is neither good nor
bad and must be evaluated by looking at the particular
circumstances at issue, with regard to the individuals involved,
the social history of the practice, and the practical consequences
for both individuals and society.

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Key Issues
• The dignity of the individual
• The role of society
• Moral ambiguity, opacity, and the limits of practical wisdom
• Society and moral and legal rights
• Public or common good
• The tragic in human life

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 Applied Ethics
• When the principles of ethics are applied to a situation, more than
principles are required.

The Professions and Professional Ethics

• The Purpose of Medicine and the Health Care System
• A definition of Medical Practice
• Professional Ethics

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 The Health Care Professions
• Models of Nursing
• bureaucratic model
• physician advocate model
• patient advocate model
• Models of Medicine
• engineering model
• priestly model
• collegial model
• contractual model
• covenant model

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.

 The Health Care Professions (cont.)
• Emerging Models and Roles
• Concierge medicine
• Ethical Diversity

© 2013, 2010, 2001 by Pearson Education, Inc. All rights reserved.